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|Title:||A Community Based Primary Prevention Programme for Type 2 Diabetes Integrating Identification and Lifestyle Intervention for Prevention: the Let’s Prevent Diabetes Cluster Randomised Controlled Trial|
|Authors:||davies, Melanie J.|
Gray, Laura J.
Let's Prevent Diabetes Team
|Publisher:||Elsevier for Academic Press|
|Citation:||Preventative Medicine, 2016, in press|
|Abstract:||Objectives: Prevention of type 2 diabetes (T2DM) is a priority in healthcare, but there is a lack of evidence investigating how to effectively translate prevention research into a UK primary care setting. We assessed whether a structured education programme targeting lifestyle and behaviour change was effective at preventing progression to T2DM in people with pre-diabetes. Materials and methods: Forty-four general practices were randomised to receive either standard care or a 6 hour group structured education programme with an annual refresher course, and regular phone contact. Participants were followed up for 3 years. The primary outcome was progression to T2DM. Results: Eight hundred and eighty participants were included (36% female, mean age 64 years, 16% ethnic minority group); 131 participants developed T2DM. There was a non-significant 26% reduced risk of developing T2DM in the intervention arm compared to standard care (HR 0.74, 95% CI 0.48, 1.14, p = 0.18). The reduction in T2DM risk when excluding those who did not attend the initial education session was also non-significant (HR 0.65, 0.41, 1.03, p = 0.07). There were statistically significant improvements in HbA1c (− 0.06, − 0.11, − 0.01), LDL cholesterol (− 0.08, − 0.15, − 0.01), sedentary time (− 26.29, − 45.26, − 7.32) and step count (498.15, 162.10, 834.20) when data were analysed across all time points. Conclusions: This study suggests that a relatively low resource, pragmatic diabetes prevention programme resulted in modest benefits to biomedical, lifestyle and psychosocial outcomes, however the reduction to the risk of T2DM did not reach significance. The findings have important implications for future research and primary care.|
|Rights:||Copyright © 2016, Elsevier for Academic Press. Deposited with reference to the publisher’s open access archiving policy. Following the embargo period this file is available under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.|
|Description:||File under embargo for 12 months from first publication.|
|Appears in Collections:||Published Articles, Dept. of Health Sciences|
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|LP paper results clear.docx||Post-review (final submitted)||378.68 kB||Unknown||View/Open|
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